Individual provider Active NPI

Kevin James Denis, DPM

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
National Provider Identifier
1073953550
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC006458 Issued in PA
Practice address
10800 Knights Rd
C/O Mary Gonzalez, Medical Education
Philadelphia, PA 19114-4200
Phone
(856) 883-0876
NPI assigned
Jun 28, 2013
Last updated
Jun 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006458 PA Primary

Addresses

Primary practice location

10800 Knights Rd
C/O Mary Gonzalez, Medical Education
Philadelphia, PA 19114-4200

Mailing address

10800 Knights Rd
C/O Mary Gonzalez, Medical Education
Philadelphia, PA 19114-4200
Phone (856) 883-0876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160811002279 PA Practitioner - Podiatry 8022302173 Reassigns benefits to 1 organization
I20230615003729 WI Practitioner - Podiatry 8022302173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3811 Spring St
Suite 102
Mount Pleasant, WI 53405-1667
Phone (262) 687-5800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue13
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006458PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Orthopaedic Specialists LLC CurrentSince Jul 1, 2016 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jun 6, 2023 Accepting new patients
Keystone Orthopaedic Specialists LLC Foot & Ankle Surgery CurrentSince Jul 1, 2016 Accepting new patients

Locations

11 Fairlane Rd
Reading, PA 19606
Phone (610) 378-8810

2758 Century Blvd
Ste 2
Wyomissing, PA 19610
Phone (610) 376-5646

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3811 Spring St
Mount Pleasant, WI 53405
Phone (262) 687-1600

3811 Spring St
Ste 102
Mount Pleasant, WI 53405
Phone (262) 687-5800

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1073953550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "address_2": "C/O MARY GONZALEZ, MEDICAL EDUCATION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "856-883-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "address_2": "C/O MARY GONZALEZ, MEDICAL EDUCATION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "856-883-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIS",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.